The Oldest Old: Reaching 90 More Likely than Ever

WASHINGTON (AP) — The rolls of America's oldest old are surging: Nearly 2 million now are 90 or over, nearly triple their numbers of just three decades ago.

It's not all good news. They're more likely than the merely elderly to live in poverty and to have disabilities, creating a new challenge to already strained retiree income and health care programs.

First-ever census data on the 90-plus population highlight America's ever-increasing life spans, which are redefining what it means to be old.

Joined by graying baby boomers, the oldest old are projected to increase from 1.9 million to 8.7 million by midcentury — making up 2 percent of the total U.S. population and one in 10 older Americans. That's a big change from over a century ago, when fewer than 100,000 people reached 90.

Demographers attribute the increases mostly to better nutrition and advances in medical care. Still, the longer life spans present additional risks for disabilities and chronic conditions such as arthritis, diabetes and Alzheimer's disease.

"If I get stuck with something I can't handle, I yell for the kids," says Betty Mae Gutoski, 85, of Muskegon, Mich., who says she expects to live past 90. After all, her father lived to 98. The colon cancer survivor lives alone and says she is "comfortable," getting occasional help with yard work from her son and grandson, who live next door.

Gutoski said in a telephone interview that she maintains her health by leading a busy life — driving, grocery shopping once a week, sewing, visiting the senior center, volunteering and meeting her friends for lunch — but she acknowledges having some fears. "My big worry is becoming a burden on my family," she said.

Richard Suzman, director of behavioral and social research at the National Institute on Aging, which commissioned the report, said cases like Gutoski's are increasingly common. Personal savings for retirement can sometimes be a problem, he said, if people don't anticipate a longer life or one with some form of disability.

An Associated Press-LifeGoesStrong.com poll in June found that more than one in four adults expect to live to at least 90, including nearly half of those currently 65 or older. A majority of adults also said they expected people in their generation to live longer than those in their parents' generation, with about 46 percent saying they expected a better quality of life in later years as well.

"A key issue for this population will be whether disability rates can be reduced," Suzman said. "We've seen to some extent that disabilities can be reduced with lifestyle improvements, diet and exercise. But it becomes more important to find ways to delay, prevent or treat conditions such as Alzheimer's disease."

According to the report, the share of people 90-94 who report having some kind of impairment such as inability to do errands, visit a doctor's office, climb stairs or bathe is 13 percentage points higher than those 85-89 — 82 percent versus 69 percent.

Among those 95 and older, the disability rate climbs to 91 percent.

Census figures show that smaller states had the highest shares of their older Americans who were at least 90. North Dakota led the list, with about 7 percent of its 65-plus population over 90. It was followed by Connecticut, Iowa and South Dakota. In absolute numbers, California, Florida and Texas led the nation in the 90-plus population, each with more than 130,000.

Traditionally, the Census Bureau has followed established norms in breaking down age groups, such as under-18 to signify children or 65-plus to indicate seniors. Since the mid-1980s, the bureau often has released data on the 85-plus population, describing them as the "oldest old" — a term coined by Suzman.

But some of those norms, at least culturally, may be shifting. Young people 18-29 more than ever are delaying their transition to work in the poor job market by pursuing advanced degrees or moving in with Mom and Dad. Older Americans, who are living longer and staying healthier than prior generations, are now more likely to work past 65.

On Thursday, the Census Bureau said it was putting out its study of the 90-plus age group at NIA's request in recognition of longer life expectancies, which are just over 78 for babies now being born.

By the time a person reaches 65, Americans are generally expected to live close to 20 years longer, up from 12 years in 1930. At age 90, their expectancy is another five years.

"Given its rapid growth, the 90-and-older population merits a closer look," said Wan He, a Census Bureau demographer who wrote the report. "The older people get, the more resources they consume because of health care, and disability rates significantly increase. This creates demands for daily care, and for families the care burden increases dramatically."

The findings come as a special congressional committee struggles to meet a Nov. 23 deadline to cut more than $1 trillion from the federal deficit over 10 years. Major sticking points are proposals to increase tax revenue as well as trim Social Security and Medicare spending, such as by increasing the Medicare eligibility age.

Other findings in the census report:

—Among the 90-plus population, women outnumber men by a ratio of nearly 3 to 1.

—Broken down by race and ethnicity, non-Hispanic whites made up the vast majority of the 90-plus population, at 88.1 percent. That's compared to 7.6 percent who were black, 4 percent Hispanic and 2.2 percent Asian.

—Most people who were 90 or older lived in households alone, about 37.3 percent. Some 37.1 percent lived in households with family or others, while about 23 percent stayed in nursing homes. About 3 percent lived in assisted living or other informal care facilities.

—Those who were 90 or older had median income of $14,760, about half of it from Social Security. About 14.5 percent of the age group lived in poverty, compared to 9.6 percent for Americans who are 65-89.

"As we look at these numbers, we see just how critically important programs like Medicare, Medicaid and Social Security are, especially for the very old in America," said David Certner, legislative policy director at AARP. "These are the people — mostly single elderly women — who can least afford a cut to their Social Security cost-of-living adjustment."

"Many more also will come to rely on Medicaid as the largest payer of long-term services and supports in our country," he said.

At the Misler Adult Day Center, a division of the Jewish Council on the Aging of Greater Washington in Rockville, Md., where seniors receive care and everyday assistance, more than a third are over 90. Physical, cognitive or emotional impairments are typical among the group but vary widely, with a 90-year-old functioning better than a 73-year-old suffering from Parkinson's disease.

Carol Neustadt, a social worker at the center, said in many of the cases adult children are taking responsibility for the care of their elderly parents, and the financial and day-to-day demands can be stressful. "Being a caregiver for a person that is needing you 24 hours a day is very difficult and demanding," she said.